April 30, 2005

Not My Moral Values

"The protocol of six Catholic hospitals run by Centura calls for rape victims to undergo an ovulation test.

If they have not ovulated, said Centura corporate spokeswoman Dana Berry, doctors tell the victims about emergency contraception and write prescriptions for it if the patient asks.

If, however, the urine test suggests that a rape victim has ovulated, Berry continued, doctors at Centura's Catholic hospitals are not to mention emergency contraception. That means the victim can end up pregnant by her rapist."

Or, in short: if a rape victim doesn't need emergency contraception, the hospitals' doctors will tell her about it; but if there's a significant chance that she might actually get pregnant as a result of her rape, and therefore does need it, they won't say a word.

I'm trying to figure out the thinking behind this. I realize that Catholics are opposed to contraception. But that doesn't necessarily mean that they must be opposed to mentioning contraception to a woman who might want it, especially when that woman has just been raped, and may not herself be Catholic. Apparently the people who write policy for these hospitals are not opposed to mentioning emergency contraception in general -- remember, it's part of the protocol to mention it to women who have not ovulated, and even to prescribe it if asked. It's only when the woman stands a significant chance of getting pregnant as a result of rape that their "consciences" kick in.

Moreover, quick access to emergency contraception can make the difference between using Plan B, which prevents conception, and either using RU486, which produces an abortion, or getting a surgical abortion. Plan B is most effective if taken within 72 hours of intercourse. If a rape victim is told about Plan B when she's being treated, then even if the hospital won't prescribe it, she stands some chance of being able to find a doctor who will before that window slams shut. If she is not told, however, she may not learn that it's possible to prevent conception until it's too late to do anything besides have the child or abort it. This is a choice that no woman should be forced to make when there is an alternative; and anyone who wants to minimize the number of abortions should think that enabling women to prevent conception after rape, rather than having to choose between abortion and carrying the child to term, is a very good idea.

The governor of Colorado has recently vetoed a bill that would have required all hospitals to inform rape victims about emergency contraception. The law would have provided a 'conscience clause' for doctors, but not for hospitals. According to Gov. Owens, that's wrong:

"It is one of the central tenets of a free society that individuals and institutions should not be coerced by government to engage in activities that violate their moral or religious beliefs," Owens wrote in his veto message. It is only his second veto of the year.

"While this bill did offer health-care professionals the right to decline to offer emergency contraception due to religious or moral beliefs, it did not offer those same protections to health-care institutions. This is wrong. And it is unconstitutional."

Wrong, Governor. To paraphrase the NRA, hospitals do not have beliefs; people do. If you protect the religious convictions of each and every person in a hospital, you have protected all the religious beliefs in that hospital, since the hospital itself does not have any religious beliefs. I am not a lawyer, but I would have thought that the reason that, say, a private religious club cannot be forced to do things that violate its members' religious beliefs, absent some compelling state interest, is not that it -- the organization -- has a first amendment right to the free exercise of religion, but rather that its members do, and that if it is a purely private organization, it is not subject to many of the laws that might otherwise constrain it (e.g., anti-discrimination statutes.)

In this case, however, both of those arguments fail. On the one hand, the consciences of individual medical professionals are protected under the statute in question. On the other, hospitals are not purely private organizations. They accept federal and state funds. They provide a public service, and do so under a variety of regulations and licensing requirements. I do not think it is too much to ask that they inform their patients, who may or may not be Catholic, about health care options those patients might want to pursue, especially in a case like this, where that option does not concern something frivolous, like removing some stray unwanted hair or mole, but whether or not to bear a child conceived in rape. Respecting individuals' religious beliefs and consciences requires giving them the information they need to make an informed decision about what to do with their bodies and their lives. In the case of women who oppose abortion, not providing this information could mean depriving her of the only way in which she could avoid bearing a child conceived in rape without violating her own moral or religious beliefs. To deprive her of this option because of the supposed need to respect the nonexistent religious beliefs of institutions is no part of any morality I recognize.

Comments

Sidereal: Phil - on not needing it. My understanding is that EC is contraceptive if there has been no fertilization yet. The rapist's sperm will still be active and can fertilize for up to something like 3(?) days. If fertilization has already occured, it acts as an abortive. This is, I assume, the basis behind the distinction.

You are correct that this is the distinction offered by those who claim EC is an abortifacient, but the distinction itself is wrong. Pregnancy begins with the implantation of the fertilized egg in the lining of the uterus, not with fertilization itself. If the zygote never takes hold, the woman never becomes pregnant. And abortion is the ending of a pregnancy, not the avoidance thereof.

This doesn't diminish the metaphysical claim that the creation of a new soul occurs at fertilization, of course, so they can make faith-based arguments that EC is immoral 'til the cows come home. But calling it an abortifacient goes beyond simple faith and into intellectually dishonest.

In 1995 informed consent was legally based in the'Dutch Medical Treatment Agreement Act' (WGBO). It basically states that any medical treatment or examination can only be done with 'informed consent'. The 'informed' bit means that the patient has to be informed in advance of what will happen, why it happends, what the consequences are and what alternatives there are.
In this case the people in the ER would not be allowed to do any examination or test without fully informing the rape victim. They *are* allowed to say that according to their believes a fetilized egg would allready be a person, they cannot be forced to prescribe EC but they HAVE to inform.

coming late to this thread, I note a certain unwillingness on the part of the pro-lifers to accept "unrealistic" analogies. So, let's try more realistic ones.

Rhanibapul Brinderjee is rushed to the ER of Krishna Hospital. There, Dr. Sanji Gupta happens to recognize her, and, because she is an untouchable, refuses to administer treatment. She dies on the table before another surgeon can be found.

Her sister, in the same auto accident, happens to be picked up by a different EMT, who takes her to the Church of The Creator Hospital. There, Dr. Albus Whiteman deliberately prescribes an overdose because he sincerely believes that it is G-d's will that the mud people be diminished -- and she is pregnant.

A few months later, Dr. Whiteman has a revelation. The true path is not to kill, which always made him uncomfortable. Better by far to dilute the mud people's blood with pure white blood. In good time, the curse of Canaan will be cleansed. So, he takes a job at a fertility clinic and adds his own sperm to all colored women's IVF tubes. He tells them it's their husband's, of course. Before he gets this job, however, he simply drugs and impregnates all of his colored female patients.

Meanwhile, over in Ali Mehmet Hospital, a Miss Rosenberg comes in for cancer treatment. Because oncologist Dr. Ibn Fatwa (a good familiy man who loves his children) believes devoutly and sincerely that all Jews are the children of Satan, he deliberately advises her to follow an ineffective and painful course of treatment. (As it turns out, Miss Rosenberg is not Jewish but rather the granddaughter of SS General Rosenberg, but it was an honest mistake on Dr. Fatwa's part.)

Drs. Gupta, Whiteman, and Fatwa are caught and arraigned. They plead not guilty, explaining that they were simply following their deeply-held religious beliefs, and that the patient was perfectly free to go to a different hospital. When Whiteman and Fatwa are asked whether they told their patients that they were withholding certain critical information, they say that informing the patient would miss the entire point. And Dr. Whiteman adds proudly that every one of his patients bore a child, so he surely did good.